Rates of Opioid Overdose Among Racial and Ethnic Minority Individuals Released From Prison

This cross-sectional study examines opioid overdose patterns by race and ethnicity among individuals released from prison in Massachusetts.


Introduction
Increases in opioid overdoses among racial and ethnic minority individuals have outpaced those among White people in the US. 1 Whether this trend holds for recently incarcerated people-a population disproportionately at risk of opioid overdose-is unclear. 2 Factors like inequitable treatment access and differential exposure to fentanyl may drive disparities within this population. 3,4 assessed opioid overdose patterns among people released from prison in Massachusetts.

Methods
Using data from the Massachusetts Public Health Data Warehouse, this cross-sectional study identified nonfatal opioid overdoses (NFOs) and fatal opioid overdoses (FOs) among adults released from prison between January 2014 and December 2019 (eAppendix in Supplement 1).We focused on events within 12 months of release because of elevated opioid overdose risk during that period.
The Harvard School of Public Health's institutional review board exempted the study and waived informed consent because this was not human participants research.We followed the STROBE reporting guideline.
Using logistic regression, we identified demographic (race and ethnicity [Hispanic; non-Hispanic American Indian, Asian/Pacific Islander, or other; non-Hispanic Black; or non-Hispanic White], sex, and age) and offense characteristics associated with experiencing NFOs and FOs.We analyzed data from October 2022 through October 2023 in SAS Studio, version 3.81.

Discussion
People released from prison experienced increasing NFO and FO rates, which were highest among White people.However, the mean annual rate of increase for NFOs and FOs was highest among Black people followed by Hispanic people and White people.
Our findings contrast with data on FO rates in Massachusetts and the US showing rates among racial and ethnic minority individuals surpassing those among White people 1,5 but align with data showing racial and ethnic minority individuals experienced the highest rates of increase in NFOs and e Cell counts between 1 and 10 were suppressed for data privacy.
f Includes obstruction of justice, habitual offender, prostitution, and some weapon possession crimes.

Table 1 .
Association Between NFOs Within 12 Months of Release From Prison and Demographic and Offense Characteristics, January 2014 to December 2019 Race and ethnicity were ascertained by self-report in the Department of Corrections data.This information was included in the analysis to identify disparities in rates of opioid overdose among racial and ethnic minority individuals released from prison in Massachusetts.Race and ethnicity information for 4 people who experienced a fatal overdose and 175 who did not were unknown.
b c The other category was not broken down further in the Department of Corrections data.d Complementary suppression was applied for data privacy.